Individual provider Active NPI

Terri Brandy Holmes, LCSW

  • Clinical Social Worker
  • Decatur, AL
National Provider Identifier
1124171137
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0793-2015C Issued in AL
Practice address
1608 4TH Ave SE
Decatur, AL 35601-4904
Phone
(256) 340-9233
NPI assigned
Jan 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0793-2015C AL Primary

Addresses

Primary practice location

1608 4TH Ave SE
Decatur, AL 35601-4904

Mailing address

1166 County Road 1716
Holly Pond, AL 35083-5802
Phone (256) 796-5482

Other names 1

  • Ms. Brandy Woods Holmes Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070423000597 AL Practitioner - Clinical Social Worker 6406951243 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0793-2015CALMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Support Services LLC CurrentSince Mar 15, 2010 Accepting new patients
Family Support Services, LLC Clinical CurrentSince Feb 27, 2007 Accepting new patients

Locations

1608 4th Ave SE
Decatur, AL 35601
Phone (256) 340-9233

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124171137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1166 COUNTY ROAD 1716",
            "city": "HOLLY POND",
            "state": "AL",
            "postal_code": "350835802",
            "telephone_number": "256-796-5482",
            "fax_number": "256-796-1776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 4TH AVE SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356014904",
            "telephone_number": "256-340-9233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "TERRI",
        "middle_name": "BRANDY",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "0793-2015C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRANDY",
            "last_name": "HOLMES",
            "middle_name": "WOODS",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Decatur, AL

Sources for this page

Verify at the official NPI Registry.